Objective: To report on a patient with endomyometrioma with atypias and to review the literature.
Design: Case report and literature review.
Setting: Clinical and pathologic.
Patient(s): A 33-year-old nulliparous woman with right flank pain and infertility.
Main outcome measure(s): Accuracy of diagnosis, hypotheses on endomyometrioma pathogenesis.
Result(s): A 33-year-old woman with an 8-cm right ovarian mass is reported. An extensive review of the literature on this rare disease revealed only nine well-documented cases with different views on pathogenesis. The final diagnosis required an accurate sampling and the aid of immunohistochemical markers.
Conclusion(s): Endomyometrioma is an extremely rare entity. None of the previous cases showed cytologic atypias. The finding of atypias, in analogy with endometriosis, suggests the müllerian metaplastic theory.